Fifteen years is not the worst case scenario on bill failure. It is roughly the time frame, on Senate bill failure, for the issue to be revisited at all, in any way that might result in real improvements. If you're REALLY lucky, twelve years. And the episode then will mostly be about recovery from the damage of the lost years, not improvement from where we are today.
It is a terrible bill, but there is no more plausible path to decent health reform via the political system than through the Senate bill. I wish I were wrong, but recent events continue to bear this out. I'd be pleasantly surprised if Anthony Weiner, a single-payer Congresscritter who wants the bill to fail, manages to sneak in a Medicare age reduction into the budget or whatever he is proposing to do.
[While the Senate bill was for the most part a corrupt give-away to the insurance industry, here's a critique of some of the more trenchant critiques of it as policy by a labour lawyer who negotiates health insurance on behalf of unions:http://www.cogitamusblog.com/2009/12/mo ... fties.html
I read some of the FDL and FDL Seminal enormous comment threads before the Coakley defeat, and let me tell you, the Defeat Coakley contingent was and is deeply deluded in so many ways. It only has salutary effects if you believe that, as apparently you do, "they need the crisis." You are in very good company: Ian Welsh not only believes they need to be defeated in 2010, but that Obama needs to be brought down in 2012, the USA must endure a right-wing populist from 2012-2016, and so on and so forth in an elaborate sequence of contingent prognostications.
I for one have no confidence that this process will have a happy ending for the left and the goals of the left and the world. It is certainly unlikely to have any positive effects on health reform. Whether it has an effect on Obama's career, Emanuel's career, etc, is a side-issue; let it be said, however, that unless there is a credible Democratic (or Green or whatever) replacement for Obama in 2012, anything achievable through the political system is hitched directly to Obama's career for the forseeable future.